Inspection on 28/06/06 for Highfield House Residential Home

This inspection was carried out on 28th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Highfield House Residential Home 12/02/10

Highfield House Residential Home 09/09/09

Highfield House Residential Home 04/09/08

Highfield House Residential Home 13/06/07

Highfield House Residential Home 02/02/06

Highfield House Residential Home 04/10/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Highfield House Residential Home 67-69 Sudell Road Darwen Lancs BB3 3HW Lead Inspector Mr Graham Oldham Key Unannounced Inspection 28th June 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highfield House Residential Home Address 67-69 Sudell Road Darwen Lancs BB3 3HW Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (If applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01254 701273 01254 701273 Dhillon Financial UK Limited Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service must employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 2nd February 2006 Date of last inspection Brief Description of the Service: Highfield House is a detached property set in its own grounds. It has a small garden at the front, a car parking area at the side and a small enclosed garden area to the rear. Accommodation is provided in single rooms, one of which has an en-suite facility, (W.C. and wash hand basin). There are bedrooms on both the ground and first floors. A passenger lift connects the two floors. There are two bathing facilities and one shower facility. The home is on a bus route into Darwen Town Centre, and is approximately half a mile from the main shopping centre. A recently updated statement of purpose and service users guide is available for residents or their families to be informed of the facilities and services the home provides. The fees for Longshaw are £324 per week. Extras residents or their families have to pay for include hairdressing, newspapers or periodicals and outings. Fees charged at Highfield House are £324.00 per week. Items such as, hairdressing, newspapers, periodicals and outings are not included; residents or their families are expected to pay for these. Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on the 28th June 2006. Much of the information gained was obtained from talking to residents and staff members. The views of residents were obtained on a variety of topics. Two residents were case tracked. Case tracking gave the inspector an overall view of the specific care for the individual resident by checking the plans of care, other documentation and talking to residents and staff. Two staff members were questioned about the care of the resident’s case tracked. Two visitors gave their viewpoints. Some of the views have been reported collectively with specific comments contained within the body of the report. The inspector took detailed notes during the inspection, which have been retained as evidence. Staff were directly and indirectly observed carrying out their tasks and interacting with residents. Paperwork examined included plans of care, assessment documentation, policies and procedures or documents relevant to each standard. A tour of the building was conducted. What the service does well: The assessment of residents was thorough to ensure the needs of residents could be met at the home. Plans of care were up to date and enabled staff to deliver effective care to residents. Residents said, ““my care is OK”, “I am very well cared for” and “staff are very kind and helpful”. The good attitude of carers allowed residents to feel satisfied with their personal care. Residents said, “visitors can come anytime” and “my son and daughter visit every day. They are lovely with visitors and offer them a cup of tea”. One visitor said, “There are no problems with visiting. They are all nice and ask if we want a drink”. Visiting was encouraged to enable residents to remain socially active. Staff said, “I can honestly say it is great. The new manager is doing an excellent job and I have a lot of respect for her. She has the sympathy of all the girls” and “I love it here. Its small and homely and we have a good staff team”. The attitude of the manager was creating a good atmosphere at the home which residents benefited from. Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Each resident must receive a contract/terms and conditions document to explain the rights of accommodation. The responsible person must ensure all staff who administer medication receive accredited training. Policies and procedures for medication must be reviewed in line with the Royal Pharmaceutical guidelines including the provision for medication to be administered outside of the home. Two staff members must witness any hand written annotations. The health and welfare of residents must be protected. The garden should be tidier and provide better facilities for residents to enjoy. Work highlighted in the last inspection must be completed as planned to provide better facilities and protect the safety of residents. The registered person should obtain a copy of the updated infection control manual for homes to help protect the health and welfare of residents and staff. The registered person must ensure there is a suitably qualified and experienced manager who is registered with the CSCI in order to meet current legislation. The registered person must ensure portable appliance testing is completed to protect the health and welfare of residents and staff. The registered person must complete a monthly report to check the quality of care and services for residents. Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 7 The registered person must produce a quality assurance system (including a business plan) to ascertain and act upon the views of all connected with the home. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP1, OP2. OP3 and OP4 The quality outcome for this standard group was adequate. This judgement has been made using available evidence including a visit to this service. An up to date statement of purpose and service user guide informed interested parties of the facilities and services the home offered. Residents did not receive a contract which explained the terms and conditions of residence. Following an assessment, prospective residents received written confirmation their needs could be met at the home. EVIDENCE: The manager had developed a statement of purpose and service user guide, which had been required at the last inspection. The documents now meet the criteria as laid down in the standards. The statement of purpose and service user guide informed residents, family members and allied professionals of the facilities and services the home provides in order to make an informed choice to reside at Highfield House. Residents had not received a contract document detailing the terms, conditions and rights for residing at the home. The manager and responsible person Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 10 must issue each resident a copy of the homes terms and conditions (as detailed within Standard 2 of the National Care Standards for Older People) to ensure their rights are protected. Two plans of care were examined during the case tracking process. Plans of care contained assessment documentation gained prior to admission. If suitable, residents received written confirmation their needs could be met at Highfield House. Resident’s case tracked said, “I had been in hospital for a few weeks. My daughter came for a look around here and then the manager came to see me. My daughter came with me when I moved in” and “I knew the home because I have had respite care here”. One visitor said, “we drew up his life history when he came here”. The assessment of residents ensured their needs could be met at the home. Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP7, OP8, OP9 and OP10 The quality outcome for this standard group was good. This judgement has been made using available evidence including a visit to this service. Plans of care contained enough information to enable staff to deliver appropriate care to residents. Residents had access to specialists to meet their health care needs. Administration of medication was safe and protected the health and welfare of residents. Residents were treated with respect and dignity to ensure they were comfortable with the personal care they received. EVIDENCE: Two plans of care were examined during the case tracking process. Plans of care detailed the care each resident received. Residents confirmed the care they received was what they required. One resident preferred to “leave care issues to my daughter”. A visitor said, “They talk to me regularly about my fathers care”. Staff members were accurate in describing the care they gave which matched what was written in the plans. Plans had been developed with the assistance of residents or a family member. Plans of care were being regularly reviewed. The manager had spent some time ensuring the plans of care were updated and said, “The plans of care are developed from Social Services and our own assessment”. Plans of care ensured staff could meet the needs of residents. Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 12 Residents case tracked said they were satisfied with medical arrangements. Resident’s case tracked said. “There are no problems getting a doctor” and “the chiropodist has been lately”. The plans of care for two residents case tracked contained information residents attended specialists such as their GP, District Nurses,, the Tissue Viability nurse, Chirpodists and Opticians. Plans contained a falls risk assessment; nutritional assessment and pressure area care assessment. Appropriate equipment was provided when necessary. Resident’s health care needs were met by attending health care specialists. There were policies and procedures for staff to follow for the administration of medication. There was a controlled drug cupboard and register. Drugs were securely stored. The medication administration chart was examined and contained no omissions. Records were maintained of medication entering and leaving the home. There was a British National Formulary. The manager did not have a copy of the Royal Pharmaceutical Societies guidelines. Staff had undertaken medication training. The temperature of stored medication was recorded. The administration of medication protected residents from possible harm. Staff were observed to treat residents with privacy and dignity when delivering personal care. One resident case tracked said, “They help me get dressed and treat me very privately”. Residents were comfortable with the way staff delivered personal care. Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP12, OP13, OP14 and OP15 The quality outcome for this standard group was good. This judgement has been made using available evidence including a visit to this service. Leisure activities provided were suitable to resident’s tastes. Visiting was open and unrestrictive to encourage families to enter the home. Residents were able to exercise choice about their lifestyle and retained some independent living. The food served at the home met residents needs. EVIDENCE: Residents spoken to during the day said, I watch television especially the world cup. I also watch wimbledon and I have been there, we have been to a concert at St Georges Hall and we went out for a meal to Old Mother Redcaps. Residents case tracked said, “I like to watch television, listening to music, reading magazines or books and going out” and “I read the paper and like to have a smoke. It’s all right. We like to keep occupied by talking to each other”. Activities were offered but the residents spoken to were more interested in talking or doing ‘their own thing’. Residents were satisfied with the choices they made to lead a fulfilling day. Residents case tracked said visiting was allowed at any time. Residents were observed entering and leaving the home at will. Visitors to the home were encouraged by the welcoming attitude of staff. Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 14 Residents said they were able to make choices such as times of going to bed, freedom of movement or choice of meals. Residents were able to retain some independence through the choices they could make. Residents case tracked were satisfied with food served at the home and said, “the food is all right” and “We have a good cook. The food is very good and we get a good choice”. Another resident commented, “The food is good. A meal was observed during the inspection and found to be tasteful and nutritious. Residents were observed to be fed in a discreet and individual manner. The kitchen staff carried out necessary environmental health checks. Food served at the home suited residents tastes. Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP16 and OP18 The quality outcome for this standard group was good. This judgement has been made using available evidence including a visit to this service. Residents knew how to make a complaint and were confident any concerns they raised would be acted upon. Staff were aware Policies and procedures to protect residents from possible abuse. EVIDENCE: There was a complaints policy and procedure which met CSCI guidelines. Two complaints had been made to the Commission since the last inspection. During the inspection aspects of the complaints were investigated and no evidence was found to support the claims. Resident’s case tracked said, “I would complain to the manager or senior carer but I have no complaints” and “I would let my daughter deal with complaints”. Resdents and their families were confident their concerns would be listened to. The home had a copy of the ‘No Secrets’ document. The home had policies and procedures for the protection of adults. The home followed the Blackburn with Darwen Adult Abuse procedures to follow a local initiative. Staff were aware of abuse issues and the whistle blowing policy. Policies were available to protect residents from financial abuse. Residents were protected from possible abuse. Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP19, OP20, OP21, OP22, OP23, OP24, OP25 and OP26 The quality outcome for this standard group was adequate. This judgement has been made using available evidence including a visit to this service. Residents lived in a clean, tidy and safe environment with the décor and furnishings to a reasonable standard, which met their needs. The garden area was untidy and not good enough to allow residents to sit out in comfort. EVIDENCE: Residents case tracked said, “I have a nice room and a very good bed. Good furniture too” and “my room is lovely and has enough furniture in it for me”. Another resident said, “I have a nice room which has lots of space”. A visitor said, “His room is nice and bright and he says it is the most comfortable bed he has ever slept in. There was a plan of routine maintenance but not all the work highlighted at the last inspection had been completed and recommendations were continued. In general the home was well maintained. Furnishings and décor was domestic in character. Each room was lockable and had a lockable facility within the room. The temperature of water was contolled to prevent residents from scalding themselves and was checked by the manager. There were aids and equipment for disabled residents. Residents were observed wandering around the home at will. The rooms visited had Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 17 been personalised to residents tastes. The environment met the needs of residents but needed some improvements. There were policies and procedures for the control of infection. The laundry was sited away from food preparation areas and contained suitable equipment to clean clothes and bed linen. The walls and floors of the laundry were clean. Hand washing facilities were available where clinical waste was produced. There were systems in place to protect residents from contracting Legionella. The managers knowledge would benefit from the new infection control guidelines for care homes. Infection control procedures protected residents and staff from possible harm. Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality outcome for this standard group was good. This judgement has been made using available evidence including a visit to this service. Resident’s needs were met by the numbers and skill mix of a well-trained staff group. The recruitment procedures were very good and safeguarded residents from possible abuse. EVIDENCE: The manager said that staffing problems, especially upon the night shift had now been overcome. The responsible person continued to cover for sickness but had completed the induction course, attended training sessions and was completing the registered managers award. Two staff files contained evidence staff had undertaken training relevant to their role. More than 50 of staff had successfully completed NVQ2 or 3 training. There was a staffing rota which demonstrated there were sufficient numbers of well trained staff on each shift. Two staff files examined during the inspection contained documents to prove the home had recruited staff in a responsible manner. References had been obtained. There was a copy of the CRB check. Other documentation such as an application form, interview form and record of induction was contained within the files. The manager was aware and said she was developing job descriptions and contracts for staff. Copies had been retained of training undertaken. Staff had received a copy of the codes of conduct. The registered manager had undertaken staff appraisal and supervision which were recorded in the staff files. Two members of staff confirmed the training and supervision had been undertaken. There was a well-trained staff team to care for the residents needs. Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP31, OP33, OP35 and OP38 The quality outcome for this standard group was adequate. This judgement has been made using available evidence including a visit to this service. The home must have a suitably qualified and experienced manager to meet the requirements of the CSCI. Quality assurance systems in use did not take into account the views of residents, family members and stakeholders to allow the manager to react to their changing needs. Financial systems protected residents from possible financial abuse. The health, safety and welfare of residents and staff was promoted and protected. EVIDENCE: The manager was awaiting registration with the Commission for Social Care Inspection and needs to gain the relevant qualifications to meet current requirements. Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 20 Quality assurance systems need to be developed for the manager to be able to gain and act upon the views of all concerned with the home. The manager said, “We only handle the pocket money of residents. Two staff sign for any monies handed over. We keep the money in a safe”. There was a secure system for handling money to protect residents from possible financial abuse. Gas and electrical appliances and installations had been maintained. There had not been an electrical portable appliance test. The fire alarm system had been maintained. The call bell system had been maintained. The lift had been maintained. There was a contract for the removal of clinical waste. There was a health and safety policy and procedure. A health and safety poster was observed in the building. The registered manager had a copy of the legislation as detailed within the standard. Staff had been trained in health and safety issues such as first aid, health and safety, infection control, food hygiene and moving and handling. CCTV cameras were not intrusive. The manager said the home was secured at night. The health and safety systems helped protect the health and welfare of residents and staff. Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 1 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 X X 2 Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP2 Regulation 5(1)(b)(c) Requirement The registered person must ensure each resident is notified in the form of a contract the terms and conditions for residing at Highfield House. The registered person must ensure that visits under this regulation are carried out, and reported, at least once a month. (carried forward from 30/3/06 The responsible person must ensure the home is managed by a suitably qualified and experienced manager. The registered person must ensure that Quality Assurance systems are in place, as detailed within this standard. (carried forward from 30/3/06 The registered person must ensure that all electrical appliances are checked to ensure the health and safety of residents and staff. Timescale for action 30/09/06 2 OP31 26 (2)(3)(4)( 5) 9(2)(b) 31/07/06 3 OP31 30/09/06 4 OP33 24 (1)(2)(3) 30/10/06 5 OP38 23 (2)(c) 30/06/06 Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations The registered person should ensure medication policies and procedures should be reviewed in line with the Royal Pharmaceutical Society of Great Britain Guidelines to address all aspects of medicines management including the provision of medication for administration outside of the home. The registered person should ensure staff involved with the administration of medication should continue to complete accredited training in respect of medicine management. The registered person should ensure all hand written annotations in the medication administration records are witnessed by two staff members. The registered person should ensure the broken window panel in the outside porch door should be replaced. The registered person should ensure the garden is upgraded to provide better facilities for residents. The shower facility in bathroom 7 requires attention to prevent it from leaking when switched on. The window in Room 26 should receive attention in order for it to close securely. The registered person should obtain a copy of the updated infection control manual for homes to help protect the health and welfare of residents and staff. The acting manager should be provided with petty cash in order to purchase day to day items. 2. OP9 3. 4. 5. 6.. 7. 8. OP9 OP19 OP19 OP21 OP25 OP26 9. OP34 Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Highfield House Residential Home DS0000064296.V295318.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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